Garousi Behzad, Rezaei Zahrasadat, Nazerian Yasaman, Yasaghi Younes, Alaei Maryam, Bahrami Zanjanbar Dorsa, Tavasol Arian, Khoshrou Alireza, Khademolhosseini Sara, Mirfakhraee Hosna
Department of Pathology, Karolinska Institute, Stockholm, Sweden.
Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Gastroenterol Hepatol Bed Bench. 2024;17(4):324-337. doi: 10.22037/ghfbb.v17i4.3057.
This survey aimed to assess the differentiation of Gastric adenocarcinoma (GA) and pancreatic adenocarcinoma (PA) via immunohistochemistry biomarkers.
GA and PA are two gastrointestinal malignancies with similarities in immunohistochemical features, making the diagnosis complex in some cases.
We searched international databases, including Google Scholar, Web of Science, PubMed, Embase, PROQUEST, and Cochrane Library, using appropriate keywords. The variance of each study was calculated using the binomial distribution formula, with all data analyzed by R version 16. Pooled odds ratios (OR), 95% confidence intervals (CI), and the I² test were calculated to evaluate the effectiveness of various immunohistochemistry biomarkers. Publication bias was assessed using funnel plots plus Begg's and Egger's tests.
Based on the finding of our study, four potent biomarkers which can distinguish GA from PA were Cadherin 17 (CDH17) with pooled OR= 3.73 (95% CI 1.58 to 8.87), P value=0.003, and I2=55.5%; Caudal-type homeobox 2 (CDX2) with pooled OR=8.99 (95% CI 4.52 to 17.90), P value= <0.001, and I2=52.2%; CK7 with pooled OR= 0.15 (95% CI 0.04 to 0.57), P value= 0.005, and I2=56.6%; CK20 with pooled OR=2.06 (95% CI 1.38 to 3.08), P value= <0.001, and I2=0%.
Our study identified CDH17, COX-2, CK7, and CK20 as potent IHC biomarkers for differentiating PA and GA. Incorporating these biomarkers into routine diagnostics is essential for improving accuracy in challenging cases, ultimately aiding timely treatment decisions and improving patient outcomes.
本调查旨在通过免疫组化生物标志物评估胃腺癌（GA）和胰腺腺癌（PA）的鉴别诊断。
GA和PA是两种胃肠道恶性肿瘤，在免疫组化特征上有相似之处，这使得在某些情况下诊断变得复杂。
我们使用适当的关键词搜索了国际数据库，包括谷歌学术、科学网、PubMed、Embase、PROQUEST和Cochrane图书馆。使用二项分布公式计算每项研究的方差，所有数据均采用R版本16进行分析。计算合并比值比（OR）、95%置信区间（CI）和I²检验，以评估各种免疫组化生物标志物的有效性。使用漏斗图以及Begg检验和Egger检验评估发表偏倚。
根据我们的研究结果，四种可区分GA和PA的有效生物标志物分别为：钙黏蛋白17（CDH17），合并OR = 3.73（95% CI 1.58至8.87），P值 = 0.003，I² = 55.5%；尾型同源盒2（CDX2），合并OR = 8.99（95% CI 4.52至17.90），P值<0.001，I² = 52.2%；细胞角蛋白7（CK7），合并OR = 0.15（95% CI 0.04至0.57），P值 = 0.005，I² = 56.6%；细胞角蛋白20（CK20），合并OR = 2.06（95% CI 1.38至3.08），P值<0.001，I² = 0%。
我们的研究确定CDH17、COX - 2、CK7和CK20为区分PA和GA的有效免疫组化生物标志物。将这些生物标志物纳入常规诊断对于提高疑难病例的诊断准确性至关重要，最终有助于及时做出治疗决策并改善患者预后。
